Station: 891 ABC Adelaide
Program: Drive
Date: 31st March 2016
Time: 5:18 PM
Compere: Ian Henschke
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia
IAN HENSCHKE: Let’s go now to Dr Rachel David, who is the chief executive of Private Healthcare Australia. Rachel, good to…
RACHEL DAVID: [Interrupts] Yes, hello.
IAN HENSCHKE: Hello, good to have you on the line. We’re getting lots of texts about this. One of the common complaints from people is what they call the soar in gap payments. Can you explain how someone who has got private health can deal with these gap payments? They might pay a couple of thousand dollars a year then go and have a baby and find out they’re still up for a couple of thousand dollars for the baby. Why is that?
RACHEL DAVID: Look, this is absolutely a concern for our members. There are a couple of ways in which a gap co-payment can be charged. First of all there is a known gap against the health insurance product, or the hospital benefit, called an excess, which the member agrees to as part of their contract with the fund. But for the most part what we’re talking about is gap payments that people don’t know about that are charged by their treating doctor or medical specialists. Now, in Australia we have a strong culture around what we call informed financial consent, so really patients should understand, but their specialist needs to tell them in advance if they charge a gap payment, and….
IAN HENSCHKE: [Interrupts] They don’t do that though, do they?
RACHEL DAVID: Yeah, well I think it’s…
IAN HENSCHKE: [Interrupts] Well, do they do it or not? Because I’m yet to meet a specialist that his first point of conversation is by the way, before we begin our discussion I will tell you that I will charge you three times the recommended rate if you go to hospital with me.
RACHEL DAVID: Well look, some of them do but not all, and we estimate that about 35 per cent of our members who have a hospital treatment actually were not told in advance the full extent of medical costs, including anaesthetists and assistants and other things.
IAN HENSCHKE: Well, that’s a lot isn’t it? That’s a lot – 35 per cent.
RACHEL DAVID: It can be, and certainly the amounts can really add up. We do encourage patients, when they see a GP who has referred them to a specialist, even as early as that, to ask their GP to tell them what the specialist is likely to charge, and to help them find out so that they have the opportunity to consider their options. A number of specialists, if they’re asked, will outline to patients what they’re likely to charge, but really no one should be in the situation where they’ve had their treatment, or even worse if they’re in hospital freaking out about having surgery and they’re told at that point. They really need to be told well in advance of any hospital treatment whether there are going to be out-of-pocket payments for that.
IAN HENSCHKE: All right, well that brings us to the point of people saying I might as well go to the hospital and say that I have no private health insurance and go in as a public patient.
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